A therapist's take on life, the world, you and me.

And nip and tuck and nip and tuck

The news has been full of reports of Heidi Montag-Pratt and her claim to have undergone 10 separate plastic surgery procedures in one day. That includes rhinoplasty (a nose job), breast augmentation, lip collagen injections, chin reduction, and god only knows what else.

“I’m beyond obsessed,” is the frequently cited quote.

It certainly sounds like it.

The death of Michael Jackson also put plastic surgery into the news this winter. Fans – and others – pored over photographs documenting the strange transformation that rendered him unrecognizable from his early days as a child star.

The question, amid all this hullaballoo, is whether there’s anything really wrong with plastic surgery.

A person clearly has a right to alter his appearance, and if he thinks the results are beautiful, that’s his business. Plenty of people choose to cover themselves with tattoos, or get a multitude of piercings. There isn’t much difference between that and having your nose straightened or your chin or breasts made larger or smaller – is there?

Not really.

We all have the right to look however we want to look, and I’m fine with plastic surgery – unless it becomes an addiction. That’s when it stops being about controlling your appearance and making yourself happy, and starts to become a compulsion that can make you miserable.

The definition of an addiction is simple:

1) you no longer receive the same pleasure from the activity; and

2) you lose control over it.

That’s where the trouble starts.

It can feel very good to have plastic surgery. If there’s some funny little quirk of your appearance that bothers you, and you finally get it addressed, it can be immensely liberating. Several of my patients have had “boob jobs” and they might laugh about it, but say in all seriousness that it made them feel more confident and that they’re happy with the results. One of my patients had a face lift, and was similarly pleased with how it made her feel – more youthful, less wrinkly, more confident.

The problem is that something that feels very good can become addictive if you become fascinated with that good feeling and try to recreate it again and again.

Along the way, you can ignore underlying problems.

There is a tendency, when you don’t feel good about yourself, to locate what bothers you in one particular physical feature. That bump on your nose, or smallish bosom, which others hardly notice, might be inflated to enormous significance to you – until you become convinced that you would feel entirely better if you could just correct that one problem.

Initially, it might work. At last – bigger breasts. Or a smaller chin. Or fewer wrinkles. Or whatever. Other people might not notice, or vaguely think you look better. But to you – it’s a vast relief.

Then you go back to do it again.

One of my patients had her nose done, and was happy with it – even if other people didn’t much notice. That’s when she decided to have her chin done, too. And then get it re-done, to get it just right. And then a piece of bone came loose, and she had to repeat that surgery.

That’s when she realized the chin surgery was probably a mistake all along. Instead of getting the same good feeling after each surgery, she only felt worse.

She realized it was becoming an addiction, and that she needed to stop using plastic surgery to escape doubts about herself, and her ability to find love. There was nothing more that a scalpel could do for her. She needed to find out why she didn’t like who she was – and address it in therapy.

It is impossible to say whether Heidi and Michael are examples of addiction, or just people who enjoyed altering their appearance to suit their own tastes. But the signs – chiefly the sheer number of surgeries – are there.

Plastic surgery tends to have diminishing returns. You can only operate on your body so many times before features scar up or grow distorted. There’s also the issue of losing what makes your appearance special in the process. The “ideal” features produced by plastic surgery tend to have a certain blandness. The goal of plastic surgery, in most instances, seems to be making someone look more like everyone else, instead of making him look more himself.

If you’re considering plastic surgery, ask yourself whether you are really addressing a simple matter of a physical quirk, or whether there’s more going on that you need to stop and examine. If the insecurity seems to involve more than just a bump or a wrinkle, it might be time to look deeper, and ask yourself what’s wrong with accepting yourself just as you are.

6 Responses

Will, I am addicted (!?) to your blog. Years back, we knew a terrific young woman who
began dating a plastic surgeon… a couple of years later: she was unrecognizable and
they broke up when he took up with another young patient! Damn. Quick thought: men with
what is reasonably considered a small penis? And, just by and by: Effexor has a couple of
tricky side effects: like making ejaculation difficult! Sending you email on “Pro Anna!” J

Thanks for your support and enthusiasm, John – please spread the word! I feel about penis size the way Abraham Lincoln felt about a man’s height. When, during a political campaign, Lincoln was asked by a little boy how tall a man should be, Honest Abe said he reckoned a man’s legs should be long enough to reach the ground.

As for Effexor…I’m planning a post soon on depression and anti-depressant medication. The side-effects, including sexual side effects, are often played down by the medical profession, but they are very real.

And a thought about “Kvetch…. kvetch:” Will, I know you do group theraphy as well as
individual. Having had some (!) group experience – isn’t it the therapist’s role to
help prevent one member just going ON and on and ON. Destroyed one group I was in as this
one person could NEVER seem to kvetch enough – and heard NO one else?!? JRS

Absolutely, John. The general guideline is that everyone in group – at least over a few sessions – should be contributing about an equal amount. A leader should intervene if someone monopolizes. The best way to do that would be to raise the issue with the group, and encourage them to express their feelings about the situation. That way, it becomes part of the group’s work, and benefits everyone by making them put their thoughts and feelings into words in front of the others.

Joni Mitchell, my favorite contemporary artist states, “happiness is the best face lift.” I think she nails it right on the head with her observation. Check out her song titled “Face Lift” off her 1998 CD called “Taming the Tiger.” She adddresses your current topic in that song with her typical style and pathos.

It’s time for your appointment

Will Meyerhofer, JD LCSW-R is a psychotherapist in private practice in TriBeCa, in New York City.
You can visit his private practice website at: www.aquietroom.com.
Will holds degrees from Harvard, NYU School of Law and The Hunter College School of Social Work, and used to be an associate at Sullivan & Cromwell before things changed...
Now, in addition to his work as a psychotherapy, he writes books and blog entries and a column for AboveTheLaw.com.